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SPA 2023 - You're Invalid? A Case Discussion where diversity, identity, cognitive decompensation, an

Abstract
Performance validity, impression management, and malingering are vital evaluation points in any assessment. But what happens when measures suggest varied interpretations of a client’s behavior? Moreso, how do you therapeutically approach an examinee who desperately wants answers and insists being honest, but elevates multiple validity scales while other scales suggest valid responding? We must inquire about these results. But, when a client has life-long trauma and marginalization, how can we without further invalidating their experience? With this case discussion, we propose that when the symptoms of concern become enmeshed with test invalidation, the invalidation itself becomes diagnostic. This case centers around Leo (a pseudonym), a 23-year-old Hispanic college student assigned male at birth. Following treatment discord and minimal progress, Leo and his therapist requested an assessment to clarify diagnoses; provide insight into Leo’s strengths, weaknesses, and personality dynamics; and inform strategies for therapeutic intervention. Concerns regarding psychosis, personality dysfunction, trauma, and impression management were prevalent. Gender identity and sense of self emerged as additional critical aspects during the evaluation. The integrative assessment process involved semi-structured and structured interviews, self-report and performance-based measures, and informant-rated inventories. Leo’s case, unique approach to testing, and interactions with the examiners are rooted in crucial issues relevant to all evaluators: validity, rapport, diversity, and clinician adaptability and humility. Attendees will be walked through Leo’s case, particularly how his response style to impression management and performance validity measures across multiple methods of measurement (i.e., MMPI-3, PAI, Rorschach, SIRS-2) generated insights beyond those pertaining to test performance, and ultimately improved our case conceptualization. Using the M-axis of the Psychodynamic Diagnostic Manual – 2 (PDM-2), we will review how Leo’s testing behaviors provided information about the 12 essential areas of mental functioning. Issues regarding diversity, rapport in assessment, and ethical considerations will be integrated throughout the case discussion.
Non-Member Price: $109
Member Price: $49
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